Please register your interest below:
Email address *
Your name: *
Your answer
Preferred phone number: *
Your answer
Would you like to receive SMS (mobile phone text) notifications about health consumer participation opportunities? You'll be able to unsubscribe at any time.
Postal address *
Your answer
Tell us about your health-related skills, experience and interests:
We're often approached to provide consumers as speakers/panel members. How comfortable/experienced are you when it comes to public speaking?
Not at all comfortable - no thank you.
Extremely confident and experienced.
That's it. Thank-you for joining HICs Consumers Connect program - also consider connecting with us on the Consumers Connect Facebook group. You can also follow Health Issues Centre on Facebook and Twitter (@HealthIssuesCtr). Is there anything else we need to know?
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.